Surgical stapler with partial pockets

ABSTRACT

A surgical stapler includes a jaw assembly at a distal end connected to a handle assembly that is configured to control the stapler and actuate the deployment of staples. The surgical stapler successfully eliminates intermediate caming portions commonly known as pushers that are located between the staples and a translating slider. The staples are located in pockets at an angle such that the base of the staple is parallel to an angled caming surface of the slider. The translating slider comes into direct contact with staples during deployment as the slider moves through each staple pocket where staples are partially supported by recesses along the slider pathway. The staples are deployed at an angle against the anvil surface. Because there are no pushers, a great deal of space is saved resulting in a much smaller diameter surgical stapler that is particularly suitable for laparoscopic stapling applications.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to and benefit of U.S. ProvisionalPatent Application Ser. No. 61/785,100 filed on Mar. 14, 2013 entitled“Surgical stapler with partial pockets” which is incorporated herein byreference in its entirety.

FIELD

This disclosure relates to surgical instruments, and more particularly,to surgical stapling instruments and staples for sequentially applying aplurality of surgical staples to body tissue.

BACKGROUND

A typical surgical stapler apparatus comprises a handle at a proximalend and two elongated jaw-like members joined together at a hinge at adistal end. The jaw-like members articulate to open and close to capturetissue between the jaw-like members. The user controls the device fromthe handle to open and close the jaw-like members, actuate deployment ofstaples and in general manipulate and control the device. One of the jawmembers carries a disposable cartridge containing staples arranged intwo or more rows. The other one of the jaw-like members comprises ananvil against which the staples are driven to deform the staple legs.Staples are driven out of the cartridge by a caming surface or sliderthat moves longitudinally against a plurality of laterally positionedpushers that push each staple out of the cartridge individually. Thecaming surface of the slider is angled to compliment the angular surfaceof the pushers. The cooperation between the angular surfaces of thepushers and the slider is a key step of the surgical stapling process.Misalignment can cause the staples to jam the device. Some staplersinclude a blade that follows the caming surface so as to cut the tissuebetween the two or more rows of delivered staples.

Surgical staplers are used in a variety of surgical techniques includinglaparoscopic and/or endoscopic or other minimally invasive surgicalprocedures in which the stapler is inserted through a cannula or tubepositioned within a small incision in a patient's body. In laparoscopic,endoscopic or minimally invasive surgery, a trocar or cannula isinserted across body tissue of a patient to access a body cavity and tocreate a channel for the insertion of a camera, such as a laparoscope.The camera provides a live video feed capturing images that are thendisplayed to the surgeon on one or more monitors. Additional trocars areinserted to create additional pathways through which surgicalinstruments, including surgical staplers, can be inserted for performingprocedures observed on the monitor. The targeted tissue location such asthe abdomen is typically enlarged by delivering carbon dioxide gas toinsufflate the body cavity and create a working space large enough toaccommodate the scope and instruments used by the surgeon. Theinsufflation pressure in the tissue cavity is maintained by usingspecialized trocars having seals that prevent the insufflation gas fromescaping and collapsing the surgical working space. Laparoscopic surgeryoffers a number of advantages when compared with an open procedure.These advantages include reduced pain and hemorrhaging and shorterrecovery times.

As laparoscopic surgery evolves to become even more minimally invasivewith incisions and cannula diameters becoming smaller and smaller,surgical staplers for use in laparoscopic/endoscopic procedures must bedesigned to fit within the small lumen of a cannula. Generally, asurgical stapler is inserted into a cannula such that the jaw-likemembers are in a closed orientation to inside the patient where thejaw-like members are opened to grasp and staple tissue. The handle ofthe stapler resides outside of the patient in control of the surgeonuser. A portion of the shaft of the stapler between the jaw-like membersand the handle is long enough to extend from outside the patient toinside the patient. During the surgical procedure, the elongate shaft ofthe stapler resides inside the cannula into which it was inserted. Thedistal jaw-like members include many components such as an anvil forforming staples, a staple cartridge with a plurality of staples, acaming surface such as a slider, pushers, a blade and other componentswhich must all be small enough to fit through a small diameter cannulaand made to function reliably and repeatedly from outside the patient.While conventional laparoscopic staplers are approximately 12millimeters in diameter, the present invention provides a surgicalstapler designed to fit inside a cannula having a diameter as small asapproximately 5-10 mm.

SUMMARY

According to one aspect of the invention, a surgical stapler isprovided. The surgical stapler includes a handle assembly and acartridge assembly removably connected to the handle assembly. Thecartridge assembly has a proximal end and a distal end and includes ajaw assembly at the distal end. The jaw assembly includes a first jawand a second jaw. The first jaw has an anvil surface and the second jawhas a top surface. The second jaw is movable relative to the first jawand the jaw assembly includes a closed position in which the anvilsurface is adjacent to a top surface and a gap is defined between thetop surface and the anvil surface. The second jaw includes a firstsurface and a second surface substantially parallel to each other andperpendicular to the top surface. The first surface and second surfacedefines a first slot between the first surface and the second surfaceextending along a length of the second jaw. The first slot has a slotwidth. The first surface includes a plurality of recesses formed intothe first surface. Each recess includes a recessed wall, a frontsidewall, and a rear sidewall. The second jaw includes a plurality ofstaple pockets. Each staple pocket is defined by the recessed wall,front sidewall, rear sidewall, a bottom wall, second surface and anopening to the top surface of the second jaw. The bottom wall is formedas part of the first surface, second surface or other surface. Anactuator is coupled to the handle assembly. The cartridge assemblyincludes a first caming surface having a thickness. The first camingsurface is movable by the actuator within the first slot and along alength of the second jaw. A plurality of staples is positioned in theplurality of staple pockets. Each staple has a staple width and ispositioned within a pocket such that a portion of the staple widthresides within the first slot and a portion of the staple width islocated and supported by the recess in the first surface. The bottomwall is formed as part of the first surface, second surface or othersurface and configured such that the first caming surface contacts aportion of the staple. With translation of the first caming surfacewithin the first slot, the first caming surface passes through one ormore staple pockets making contact with that portion of the staple widthresident within the first slot to urge the staple out of the opening andagainst the anvil surface.

According to another aspect of the invention, a surgical stapler isprovided. The surgical stapler includes a handle assembly and acartridge assembly removably connected to the handle assembly. Thecartridge assembly includes a proximal end and a distal end. A jawassembly is located at the distal end of the cartridge assembly. The jawassembly has a longitudinal axis and includes a first jaw connected to asecond jaw. The first jaw includes an anvil surface that is a smooth andflat without any staple-forming pockets. The second jaw has a topsurface. The second jaw is movable relative to the first jaw such thatthe jaw assembly includes a closed position in which the anvil surfaceis adjacent to a top surface and a gap is defined between the topsurface and the anvil surface. The second jaw includes a plurality ofstaple pockets. Each staple pocket has a longitudinal axis and anopening at the top surface. An actuator is coupled to the handleassembly. At least one caming surface is movable by the actuator withinthe second jaw and along a length of the second jaw. A plurality ofstaples is positioned inside the staple pockets. Each staple includes atleast a first leg and a second leg interconnected by base and an openconfiguration for penetrating tissue and a closed configuration forretaining tissue. The plurality of staples is located inside the staplepockets in an open configuration. With the jaw assembly in a closedposition, translation of the caming surface along the second jaw ejectsthe staples from the staple pockets toward the anvil surface of thefirst jaw to deform the staples from an open configuration against theanvil surface to a closed configuration.

According to another aspect of the invention, a surgical stapler isprovided. The surgical stapler includes a handle assembly and acartridge assembly removably connected to the handle assembly. Thecartridge assembly includes a proximal end and a distal end. A jawassembly is located at the distal end of the cartridge assembly. The jawassembly has a longitudinal axis and includes a first jaw connected to asecond jaw. The first jaw includes an anvil surface that is a smooth andflat without any staple-forming pockets. The second jaw has a topsurface. The second jaw is movable relative to the first jaw such thatthe jaw assembly includes a closed position in which the anvil surfaceis adjacent to a top surface and a gap is defined between the topsurface and the anvil surface. The second jaw includes a plurality ofstaple pockets. Each staple pocket has a longitudinal axis and anopening at the top surface. An actuator is coupled to the handleassembly. At least one caming surface is movable by the actuator withinthe second jaw and along a length of the second jaw. A plurality ofstaples is positioned inside the staple pockets. Each staple includes anopen configuration for penetrating tissue and a closed configuration forretaining tissue. The plurality of staples is located inside the staplepockets in an open configuration. With the jaw assembly in a closedposition, translation of the caming surface along the second jaw ejectsthe staples from the staple pockets toward the anvil surface of thefirst jaw to deform the staples from an open configuration against theanvil surface to a closed configuration.

According to another aspect of the invention, a surgical stapler isprovided. The surgical stapler includes a handle assembly and acartridge assembly removably connected to the handle assembly. Thecartridge assembly includes a proximal end and a distal end and a jawassembly at the distal end. The jaw assembly has a longitudinal axis andincludes a first jaw connected to a second jaw. The first jaw has ananvil surface and the second jaw has a top surface. The second jaw ismovable relative to the first jaw such that the jaw assembly includes aclosed position in which the anvil surface is adjacent to a top surfacedefining a gap between the top surface and the anvil surface. The secondjaw includes a plurality of staple pockets having a plurality ofopenings at the top surface. The staple pockets are arranged in at leastthree substantially parallel rows along the top surface of the secondjaw. The stapler includes an actuator coupled to the handle assembly andat least one caming surface movable by the actuator along a length ofthe second jaw. A blade is provided and configured to be movable withinthe gap defined between the top surface and the anvil surface when thefirst jaw and second jaw are in the closed position. The blade isconfigured to sever tissue located between the first jaw and the secondjaw defining a cutting line. A plurality of staples is positioned insidethe plurality of staple pockets. The caming surface is configured toeject staples from the staple pockets and against the anvil surface todeform the staples with translation of the caming surface along thesecond jaw. The second jaw includes a number of rows of staple pocketson one side of the blade that is different from a number of rows ofstaple pockets on the other side of the blade cutting line.

According to another aspect of the invention, a surgical stapler isprovided. The surgical stapler includes a handle assembly removablyconnected to a cartridge assembly. The cartridge assembly includes a jawassembly at the distal end. The jaw assembly has a longitudinal axis andincludes a first jaw connected to a second jaw. The first jaw has alongitudinal axis and an anvil surface. The anvil surface includes aseries of parallel channels. Each channel has a length and a surfacethat may be any shape, semi-cylindrical, curved, concave, square, orrectangle and configured for assisting in closing the staple in thedesired direction. The lengths of the channels are perpendicular to thelongitudinal axis of the jaw assembly. The second jaw has a top surfaceand is movable relative to the first jaw. The jaw assembly has a closedposition in which the anvil surface is adjacent to a top surface and agap is defined between the top surface and the anvil surface. The secondjaw includes a plurality of staple pockets. Each staple pocket has anopening at the top surface. An actuator coupled to the handle assemblyis provided. The stapler includes at least one caming surface movable bythe actuator within the second jaw and along a length of the second jaw.A blade is provided and configured to be movable within the gap definedbetween the top surface and the anvil surface when the first jaw andsecond jaw are in the closed position. The blade is configured to severtissue located between the first jaw and the second jaw defining acutting line. A plurality of staples is positioned inside the staplepockets. Each staple includes an open configuration for penetratingtissue and a closed configuration for retaining tissue. The plurality ofstaples is located inside the staple pockets in an open configuration.The channels extend across the anvil surface on either side of thecutting line. With the jaw assembly in a closed position, translation ofthe caming surface along the second jaw ejects the staples from thestaple pockets toward the anvil surface of the first jaw to deform thestaples from an open configuration against the anvil surface to a closedconfiguration. The channels are configured to permit the formation ofstaples into a closed configuration.

According to another aspect of the invention, a surgical stapler isprovided. The surgical stapler includes a handle assembly removablyconnected to a cartridge assembly. The cartridge assembly has a proximalend and a distal end and a jaw assembly located at the distal end. Thejaw assembly has a longitudinal axis and includes a first jaw connectedto a second jaw. The first jaw has a longitudinal axis and an anvilsurface. The anvil surface includes a series of parallel channels. Eachchannel has a length and a surface that may be any shape, curved,concave, semi-cylindrical, square, or rectangle and configured forassisting in closing the staple in the desired direction. The length ofeach channel is parallel to the longitudinal axis of the jaw assemblyand extends along the anvil surface. The second jaw has a top surface.The second jaw is movable relative to the first jaw. The jaw assemblyincludes a closed position in which the anvil surface is adjacent to atop surface and a gap is defined between the top surface and the anvilsurface. The second jaw includes a plurality of staple pockets having aplurality of openings at the top surface. The staple pockets arearranged in parallel rows along the top surface of the second jaw. Anactuator is included and coupled to the handle assembly. At least onecaming surface is movable by the actuator within the second jaw andalong a length of the second jaw. The surgical stapler further includesa plurality of staples positioned inside the staple pockets. Each stapleincludes an open configuration for penetrating tissue and a closedconfiguration for retaining tissue. The plurality of staples is locatedinside the staple pockets in an open configuration. With the jawassembly in a closed position, translation of the caming surface alongthe second jaw ejects the staples from the staple pockets toward theanvil surface of the first jaw to deform the staples from an openconfiguration against the anvil surface to a closed configuration. Thechannels are configured to permit the formation of staples into a closedconfiguration.

According to another aspect of the invention, a surgical stapler isprovided. The surgical stapler includes a handle assembly removablyconnected to a cartridge assembly. The cartridge assembly has a proximalend and a distal end and includes a jaw assembly at the distal end. Thejaw assembly includes a first jaw connected to a second jaw. The firstjaw has an anvil surface and the second jaw has a top surface. The firstjaw is connected to the second jaw such that the second jaw is movablerelative to the first jaw. The jaw assembly includes a closed positionin which the anvil surface is adjacent to a top surface and a gap isdefined between the top surface and the anvil surface. The second jawincludes a first surface and a second surface substantially parallel toeach other and perpendicular to the top surface. The first surfaceincludes a plurality of recesses formed into the first surface. Eachrecess has a recessed wall, a front sidewall, a rear sidewall and abottom wall. The second jaw includes a plurality of staple pockets. Eachstaple pocket is defined by each recess including an opening to the topsurface of the second jaw. The first surface includes a plurality oflongitudinally extending grooves formed into the first surface. Thesurgical stapler further includes an actuator coupled to the handleassembly. A first caming surface is also provided. The first camingsurface includes a plurality of projections sized and configured to fitwithin the longitudinally extending grooves of the first surface andtranslate therein. The first caming surface is movable by the actuatoralong a length of the second jaw. The surgical stapler includes aplurality of staples positioned in the plurality of staple pockets. Eachstaple has a staple width and is positioned within and supported by astaple pocket. With translation of the first caming surface along thejaw assembly, the projections of the first caming surface pass throughone or more staple pockets making contact with a portion of the staplewidth to urge the staple out of the opening and against the anvilsurface.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a surgical stapler according to thepresent invention.

FIG. 2 is a side view of a stapler cartridge assembly according to thepresent invention.

FIG. 3 is semi-transparent side view a proximal end of a staplercartridge assembly according to the present invention.

FIG. 4 is side view of an actuator shaft and I-beam according to thepresent invention.

FIG. 5 is a perspective view of a distal end of an actuator shaft andI-beam according to the present invention.

FIG. 6 is a perspective view of an I-beam according to the presentinvention.

FIG. 7 is a side view of an I-beam according to the present invention.

FIG. 8 is an end view of an I-beam according to the present invention.

FIG. 9 is a perspective view of an end effector with jaws in an openposition according to the present invention.

FIG. 10 is a bottom perspective view of an upper jaw according to thepresent invention.

FIG. 11 is an end view of an upper jaw according to the presentinvention.

FIG. 12 is a bottom perspective view of an upper jaw with curvedchannels according to the present invention.

FIG. 13 is an end view of an upper jaw with curved channels according tothe present invention.

FIG. 14 is a top perspective view of a lower jaw according to thepresent invention.

FIG. 15 is a side view of a lower jaw according to the presentinvention.

FIG. 16 is a top rear perspective view of a lower jaw according to thepresent invention.

FIG. 17 is a top perspective view of a staple cartridge according to thepresent invention.

FIG. 18 is a top view of a staple cartridge according to the presentinvention.

FIG. 19 is an exploded top perspective view of a staple cartridgeaccording to the present invention.

FIG. 20 is a side view of first plate of a staple cartridge according tothe present invention.

FIG. 21 is a top perspective sectional view of a staple cartridgeaccording to the present invention.

FIG. 22 is a top perspective sectional view of a staple cartridge,I-beam and slider according to the present invention.

FIG. 23 is a schematic of removed tissue resolved with an asymmetricstaple cartridge according to the present invention.

FIG. 24 is a schematic of an asymmetric stapler grasping tissueaccording to the present invention.

FIG. 25 is a schematic of an asymmetric stapler with a curved endeffector according to the present invention.

FIG. 26 is a top perspective view of a slider according to the presentinvention.

FIG. 27 is an end view of a slider according to the present invention.

FIG. 28 is a side elevational view of a slider according to the presentinvention.

FIG. 29 is a top view of a slider according to the present invention.

FIG. 30 is a top rear perspective view of a slider according to thepresent invention.

FIG. 31 is a top perspective view of a staple according to the presentinvention.

FIG. 32 is a side view of a staple according to the present invention.

FIG. 33 is an end view of a staple according to the present invention.

FIG. 34 is a top view of a staple according to the present invention.

FIG. 35 is a top perspective view of a staple in a closed configurationaccording to the present invention.

FIG. 36 is a side elevational view of a staple in a closed configurationaccording to the present invention.

FIG. 37 is an end view of a staple in a closed configuration accordingto the present invention.

FIG. 38 is a side view of a staple with barbs according to the presentinvention.

FIG. 39 is a side view of a staple with barbs according to the presentinvention.

FIG. 40 is a top perspective sectional view of a four-pronged staple ina staple pocket, and a slider according to the present invention.

FIG. 41 is a semi-transparent, top perspective, sectional view of aslider and a plurality of four-pronged staples loaded in a lower jaw anda slider according to the present invention.

FIG. 42A is a top perspective view of a four-pronged staple according tothe present invention.

FIG. 42B is a side elevational view of a four-pronged staple accordingto the present invention.

FIG. 42C is a top view of a four-pronged staple according to the presentinvention.

FIG. 42D is an end view of a four-pronged staple according to thepresent invention.

FIG. 43A is a top perspective view of a four-pronged staple according tothe present invention.

FIG. 43B is a top perspective view of a staple according to the presentinvention.

FIG. 44A is a top perspective view of a four-pronged staple according tothe present invention.

FIG. 44B is a side elevational view of a four-pronged staple accordingto the present invention.

FIG. 44C is a top view of a four-pronged staple according to the presentinvention.

FIG. 44D is an end view of a four-pronged staple according to thepresent invention.

FIG. 45A is a top perspective view of a four-pronged staple according tothe present invention.

FIG. 45B is a side elevational view of a four-pronged staple accordingto the present invention.

FIG. 45C is a top view of a four-pronged staple according to the presentinvention.

FIG. 45D is an end view of a four-pronged staple according to thepresent invention.

FIG. 46A is a top perspective view of a six-pronged staple according tothe present invention.

FIG. 46B is a side elevational view of a six-pronged staple according tothe present invention.

FIG. 46C is a top view of a six-pronged staple according to the presentinvention.

FIG. 46D is an end view of a six-pronged staple according to the presentinvention.

FIG. 47A is a side sectional view of a staple inside a staple pocket ofa lower jaw and an upper jaw according to the present invention.

FIG. 47B is a side sectional view of a staple contacting the upper jawaccording to present invention.

FIG. 47C is a side sectional view of a staple contacting the upper jawand deforming according to the present invention.

FIG. 48 is a top view of a plurality of staples connected to a backboneaccording to the present invention.

FIG. 49 is a top perspective view of a staple cartridge inserted in alower jaw according to the present invention.

FIG. 50 is a top perspective view of a staple cartridge inserted in alower jaw according to the present invention.

FIG. 51 is a top perspective view of a staple cartridge being insertedinto a lower jaw according to the present invention.

FIG. 52 is a top perspective view of a staple cartridge being insertedinto a lower jaw according to the present invention.

FIG. 53 is a transparent sectional view of a handle assembly accordingto the present invention.

FIG. 54 is a rear top perspective view of an end effector with an upperjaw in an open position according to the present invention.

FIG. 55 is a rear top perspective view of an end effector with the upperjaw in a closed position according to the present invention.

FIG. 56 is a side elevational view of an end effector with an upper jawin an open position according to the present invention.

FIG. 57 is a side elevational view of an end effector with an upper jawin a closed position according to the present invention.

FIG. 58 is a rear, top perspective, sectional view of a surgical stapleraccording to the present invention.

FIG. 59 is a rear, semi-transparent, top perspective, sectional view ofa handle assembly according to the present invention.

FIG. 60 is a side elevational, sectional view of a handle assemblyaccording to the present invention.

FIG. 61 is a semi-transparent, side elevational, sectional view of anend effector according to the present invention.

FIG. 62 is a semi-transparent, side elevational, sectional view of anend effector according to the present invention.

FIG. 63 is a semi-transparent, top perspective, sectional view of an endeffector according to the present invention.

FIG. 64 is a semi-transparent, side elevational, sectional view of ahandle assembly according to the present invention.

FIG. 65 is a semi-transparent, top perspective, sectional view of ahandle assembly according to the present invention.

FIG. 66 is a semi-transparent, side elevational view of an end effectorwith an upper jaw in an open position according to the presentinvention.

FIG. 67 is a semi-transparent end view of an end effector according tothe present invention.

FIG. 68 is a top perspective, sectional view of a plate, slider andstaple according to the present invention.

DETAILED DESCRIPTION

Referring to FIG. 1, there is shown a perspective view of a surgicalstapler 10 according to the present invention. The stapler 10 iscomprised of a handle assembly 12 removably connected to a staplercartridge assembly 14. The handle assembly 12 is configured to controlthe instrument and actuate deployment of staples located in the distalend of the stapler cartridge assembly 14. After the staples have beenexpended from the stapler 10, the stapler cartridge assembly 14 isremoved from the handle assembly 12 and a new stapler cartridge assembly14 is connected to the handle assembly 12 for continued stapling.

Turning to FIG. 2, the stapler cartridge assembly 14 will now bediscussed in detail. The stapler cartridge assembly 14 includes aconnector 16 at the proximal end and an end effector 18 at the distalend. An outer tube 20 is connected to the end effector 18 at the distalend and to the connector 16 at the proximal end. An actuator shaft 22 isdisposed inside the lumen of the outer tube 20. The outer tube 20 issubstantially cylindrical having an outer diameter of approximately 5-10mm. The actuator shaft 22 is configured to slide longitudinally relativeto the outer tube 20. Detail of the proximal end of the staplercartridge assembly 14 is shown in FIG. 3.

Turning to FIG. 3, the proximal end of the stapler cartridge assembly 14is shown. The connector 16 includes a bolt 24 that extends laterallyoutwardly from the outer surface of the connector 16. A similar bolt 24extends on the opposite side of the connector 16 and is not visible inFIG. 3. The bolt 24 is configured for a bayonet-like connection with thehandle assembly 12 of the stapler 10 that includes a complementary slotfor receiving the bolt 24 to secure the cartridge assembly 14 to thehandle assembly 12. FIG. 3 also illustrates the actuator shaft 22 movedproximally relative to the outer tube 20 when compared to FIG. 2 inwhich the actuator shaft 22 is shown to be moved more distally relativeto the outer tube 20. As seen in FIG. 3, the proximal end of theactuator shaft 22 includes a bolt 26 that extends laterally outwardlyfrom the actuator shaft 22. The bolt 26 is configured for a bayonet-likeconnection with an actuator shaft of the handle assembly 12 whichincludes a complementary slot for receiving the bolt 26. Mating the bolt24 of the connector 16 to handle assembly 12 simultaneously mates thebolt 26 of the actuator shaft 22 to the actuator shaft of the handleassembly 12. When connected to the handle assembly 12, the handleassembly 12 is used to move the actuator shaft 22 forward and backwardinside the outer tube 20 to effect opening and closing of the distaljaw-like members and the deployment of staples.

Turning to FIG. 4, the actuator shaft 22 will now be described. Theactuator shaft 22 is an elongated shaft having a substantiallycylindrical proximal portion 28 having actuator bolts 26 at the proximalend for connection with the actuator of the handle assembly 12. Thesubstantially cylindrical portion 28 is sized to fit closely insidelumen of the outer tube 20. The cylindrical portion 28 is connected withpins to an extended I-beam portion 30 toward the distal end of theactuator shaft 22. The distal end of the actuator shaft 22 includes anI-beam 32 connected to the extended I-beam portion 30. The I-beam 32 isconnected to the extended I-beam portion 30 as shown in FIG. 5.

Turning now to FIGS. 6-8, the I-beam 32 will now be described. TheI-beam 32 includes a top portion 34 and a bottom portion 36interconnected by a middle portion 38. The top portion 34 includes abeveled front end 40 and a curved top. The middle portion 38 includes ablade 42 and an angled portion 44 at the front end. At the back end, themiddle portion 38 includes an extension 46 for connecting with theextended I-beam portion 30 as shown in FIG. 5. The bottom portion 36leads the front end of the I-beam 32 and includes a curved bottom. Thefront-elevational view of the I-beam is shown in FIG. 8 whichillustrates the profile to be in the shape of a capital letter “I”.

Turning now to FIG. 9, the end effector 18 will be described. The endeffector 18 includes an upper jaw 48 hinged to a lower jaw 50. At leastone staple cartridge 52 containing a plurality of staples 54 is disposedinside the lower jaw 50. The at least one staple cartridge 52 isconfigured to received a plurality of staples 54 that are not visible inFIG. 9. The end effector 18 further includes a slider 56 configured tourge the staples 54 out of the cartridge 52. The slider 56 is notvisible in FIG. 9.

Turning to FIGS. 10-11, the upper jaw 48 will now be described. Theupper jaw 48 includes a flat anvil surface 58 or plate defining acentral slot 60. The central slot 60 is elongated with an open proximalend. The central slot 60 is sized and configured to receive at least aportion of the middle portion 38 of the I-beam 32 such that the I-beam32 slides relative to the upper jaw 48 inside and along the central slot60. The outer surface of the upper jaw 48 is curved and substantiallysemicircular in shape to conform to a cylindrical lumen of a cannula inwhich it is inserted. The upper jaw 48 includes a top cover 62. The topcover 62 forms part of the outer circumference of the upper jaw 48 andtogether with the anvil surface 58 define therebetween a passageway 64for receiving the top portion 34 of the I-beam 32 such that the topportion 34 slides relative to the upper jaw 48 inside the passageway 64.At the proximal end, the upper jaw 48 further includes flanges havingapertures for receiving pins and connecting to the lower jaw 50.

A typical anvil of a conventional surgical stapler includesstaple-forming pockets in the surface of the anvil that are designed toreceive the legs of a staple and guide, angulate and bend the staplelegs as the staple is urged against the anvil. These surface formationsof a typical anvil aid in the deformation of the staple as it isdeployed to achieve proper staple formation. Any misalignment betweenthe staple-forming pockets and the staple leads to the staples missingthe staple forming pockets, resulting in catastrophic failure of thestaple line. The detailed staple-forming pockets introduce significantmanufacturing difficulties and increase costs of production.Advantageously, the present invention does not utilize staple-formingpockets in the surface of the anvil. The anvil surface is smooth and/orflat. By redesigning the staple to not require anvil pockets to beformed, anvil pockets are eliminated completely simplifying the designwhile advantageously bringing an additional level of reliability to thestapler 10. Slight misalignment is no longer a concern especially withflat plate designs. The simplified design is also a major benefit formanufacturing as the anvil costs are reduced and the need for ultra-highprecision parts to maintain perfect alignment are no longer needed. Inone variation, the anvil surface 58 is completely flat as shown in FIG.10. In another variation shown in FIG. 12, the anvil surface includes aseries of curved channels 66 having substantially smooth surfacesagainst which staples can deform into the proper configuration. Thelengths of the channels 66 are perpendicular to the longitudinal axis ofthe upper jaw 48. The wave-like arrangement of channels 66 defines acentral slot 60 in the anvil surface and reduces the need for criticalalignment from side to side. Critical alignment of the staple is notrequired as the channels 66 are wide enough to easily receive the staplelegs. The curvature of the channels 66 assists in deflecting the staplelegs in the proper direction. In another variation, the anvil surfaceincludes two or more longitudinal curved channels 68 that extend alongthe axis of the device as shown in FIG. 13. The elongate curved channels66, 68 permit the formation of staples 54 without the worry and cost ofproper alignment of each staple with each staple-forming pocket.Although the channels 66, 68 are shown to be curved, they can havesquare or rectangular cross-sections for assisting in closing the staplein the desired direction.

Referring now to FIGS. 14-16, the lower jaw 50 will be described. Thelower jaw 50 is an elongate piece sized and configured tocomplementarily mate with the upper jaw 48. The lower jaw 50 has an opentop and a curved outer surface. The cross-section of the lower jaw 50 issubstantially semi-circular in shape except at the proximal end where itis substantially circular in cross-section. The depending flanges of theupper jaw 48 attach to the lower jaw 50 via pins inserted into aperturesin the lower jaw 50 near the proximal end. When attached together, theupper jaw 48 and lower jaw 50 create a substantially cylindricalprofile. The distal end of the lower jaw 50 is angled and thecylindrical proximal end defines a vertically oriented slot 70 visiblein FIG. 16. This slot 70 is sized and configured to receive the extendedI-beam portion 30 of the actuator shaft 22 with the I-beam itself 32residing inside the lower jaw 50 distal of the slot 70. The cylindricalproximal end is adapted for attachment to the outer tube 20. The lowerjaw 50 further includes a staple cartridge receiving portion 72. Whenone or more staple cartridges 52 are inserted into the staple cartridgereceiving portion 72 of the lower jaw 50, a passageway is definedbetween the one or more staple cartridges 52 and a bottom cover 74. Thispassageway is sized and configured to receive the bottom portion 36 ofthe I-beam 32 such that the bottom portion 36 slides longitudinally withrespect to lower jaw 50 inside the passageway. Inside the staplecartridge receiving portion 72, there is a ledge 76 at the distal endfor securing the front end of one or more staple cartridges 52. A tongue78 is formed at the proximal end for mating with a groove of the staplecartridge 52 to secure the proximal end of the staple cartridge 52 tothe lower jaw 50. A cartridge retainer 80, shown in FIG. 9, covers thedistal end tongues of staple cartridges 52 after being inserted into thelower jaw 50.

Referring now to FIGS. 17-22, the staple cartridge 52 will be described.The staple cartridge 52 comprises first plate 82, a second plate 84 anda third plate 86 connected together. The plates 82, 84, 86 are made fromany polymer material, metal such as aluminum or stainless steel or glassfilled nylon. The first plate 82 is elongate and substantiallyrectangular in shape and includes an outer surface 88 and an innersurface 90. The outer surface 88 is smooth and the inner surface 90 isformed with a plurality of staple holding locations 92. The stapleholding locations 92 are recesses formed in the inner surface 90 of thefirst plate 82. Each staple holding location 92 is substantiallyU-shaped and defined by a front sidewall 94 formed oppositely andsubstantially parallel to a rear sidewall 96. The rear sidewall 96 isinterconnected to a bottom wall 98 forming an L-shaped continuous walldefining a gap 100 between the bottom wall 98 and the front sidewall 94.In one variation, no gap 100 is formed. Instead, the bottom wall 98interconnects with both the front sidewall 94 and rear sidewall 96 toform a complete U-shaped staple holding location 92. The U-shaped stapleholding locations are angled approximately 30-90 degrees with 90 degreesbeing a vertical non-angled orientation. The recessed wall 99 isrecessed with respect to the inner surface 90. The first plate isapproximately 0.020-0.025 inches thick and the depth of each recess orthickness of each sidewall 94, 96, 98 is approximately 0.005-0.008inches. The staple holding locations 92 are configured for partiallyreceiving and holding a complementary, substantially U-shaped staplethat is thicker than the thickness of the sidewalls 94, 96, 98. Thedistal end of the first plate 82 includes a tongue 102 and the proximalend of the first plate 82 includes a groove 104 for connecting with theledge 76 and tongue 78 of the lower jaw 50. The distal end and proximalend of the first plate 82 further include spacers 103, 105,respectively, that extend inwardly and are configured to space the innersurface 90 from the second plate 84. The first plate 82 is made of metalor plastic.

The second plate 84 or middle shim 84 is a thin elongate substantiallyrectangular shaped plate of metal or plastic having smooth outersurfaces. The second plate 84 is approximately 0.010-0.020 inches thick.The distal end includes a tongue 106 and the proximal end includes agroove 108 that are configured for connecting with the ledge 76 andtongue 78 of the lower jaw 50. In another variation, two second plates84 a, 84 b are provided and each is approximately 0.005 inches inthickness. The first second plate 84 a is sprung such that the firstsecond plate exerts a force towards the first plate 82 and the othersecond plate 84 b is also sprung such that it exerts a force towards thethird plate 86.

The third plate 86 is substantially identical to and a mirror image ofthe first plate 82. The third plate 86 is elongate and substantiallyrectangular in shape and includes an outer surface 110 and an innersurface 112. The outer surface 110 is smooth and the inner surface 112is formed with a plurality of staple holding locations 92 substantiallyidentical to and a mirror image of the staple holding locations 92 ofthe first plate 82. The staple holding locations 92 are recesses formedin the inner surface 112 of the third plate 86. Each staple holdinglocation 92 is substantially U-shaped and defined by two oppositelyformed substantially parallel sidewalls, a front sidewall 94 and a rearsidewall 96. The rear sidewall 96 is interconnected to a bottom wall 98forming an L-shape continuous wall defining a gap 100 between the bottomwall 98 and the front sidewall. In one variation, no gap 100 is formed.Instead, the bottom wall 98 interconnects with both the front sidewall94 and rear sidewall 96 to form a complete U-shaped staple holdinglocation 92. The recessed wall 99 is recessed with respect to the innersurface 112. The U-shaped staple holding locations are angledapproximately 30-90 degrees with 90 degrees being a vertical non-angledorientation. The third plate is approximately 0.020-0.025 inches thickand the depth of each recess or thickness of each sidewall 94, 96, 98 isapproximately 0.005-0.008 inches. The staple holding locations 92 areconfigured for partially receiving and holding a complementary,substantially U-shaped staple that is thicker than the thickness of thesidewalls 94, 96, 98. The distal end of the third plate 82 includes atongue 114 and the proximal end of the third plate 86 includes a groove116 for connecting with the ledge 76 and tongue 78 of the lower jaw 50.The distal end and proximal end of the third plate 82 further includespacers 115, 117, respectively, that extend inwardly and are configuredto space the inner surface 112 of the third plate 86 from the secondplate 84.

The first plate 82, second plate 84 and third plate 86 are connected orsandwiched together to form a staple cartridge 52 having two rows ofstaggered staple pockets 118 for placement on one side of the blade 42of the I-beam 32. The staple pockets 118 are staggered to form a morecomplete closed line of staples. A second staple cartridge 52 is placedon the other side of the blade 42 of the I-beam 32 forming two rows ofstaple pockets 118 on the other side of the blade 42 for a total of fourrows of staple pockets 118. The cartridges 52 can be modified withadditional plates to create more than two rows of staples and caninclude three or four rows of staples on each side of the I-beam 32. Thestaple pockets 118 are defined by the recessed wall 99, the frontsidewall 94, rear sidewall 96, bottom wall 98 and the outer surface ofthe second plate 84. Each pocket 118 includes an open top and apartially open bottom. In one variation, the bottom is closed. Becausethe spacers 103, 105 of the first plate 82 space the inner surface 90 ofthe first plate 82 from the second plate 84, a first slot 120 is formedbetween the first plate 82 and the second plate 84. The first slot 120is configured for receiving a first angled caming surface of the slider56 that will be described in greater detail herein below. The first slot120 intersects with the first row of staple pockets 118. Because thespacers 115, 117 of the third plate 86 space the inner surface 112 ofthe third plate 86 from the second plate 84, a second slot 122 is formedbetween the third plate 86 and the second plate 84. The second slot 122is configured for receiving a second angled caming surface of the slider56 that will be described in greater detail herein below. The secondslot 122 intersects with the second row of staple pockets 118. The sameconfiguration appears on the staple cartridge disposed on the other sideof the I-beam 32. The staple cartridge 52 is considered to be a singleunit holding all the staples on either side of the I-beam 32 oralternatively, there are two staple cartridge units, one disposed oneither side of the I-beam 32.

Turning now to FIG. 22, there is shown another variation of the staplecartridge 52 wherein the second plate 84 is not smooth but also includesa plurality of staple holding locations 124 similar to the stapleholding locations 92 of the first and third plates 82, 86. In thisvariation, both opposite outer surfaces of the second plate 84 includerecesses defined by a recessed wall 126 that is recessed from the outersurface, a front sidewall 128, a rear sidewall 130 and a bottom wall(not shown). The bottom wall may or may not include a gap. The stapleholding locations 124 in a first outer surface of the second plate 84are located opposite to the staple holding locations 92 of the firstplate 82 which together define the staple pocket 118. Also, the stapleholding locations 124 formed in a second outer surface of the secondplate 84 are located opposite to the staple holding locations 92 of thethird plate 86 which together define the staple pockets 118. The stapleholding locations 124 have the same angle as their opposite stapleholding locations 92 in the first and third plates 82, 86. Each pocket118 defined by staple holding locations 92 and 124 are configured toreceive substantially U-shaped staples 54 such that they are supportedby the sidewalls yet include an unsupported portion of the staple 54that resides in the first and second slots 120, 122. This unsupportedportion of the staple 54 that resides in either the first or secondslots 120, 122 is exposed for contact with the angled caming surface ofthe slider 56 as it passes through the slot and urges the staple 54upwardly out of the pocket 118. In this variation in which the secondplate 84 includes staple holding locations 124, the depth of the staplereceiving portions 92, 124 are approximately 0.005 inches each and thewidth of each slot 120, 122 is approximately 0.005-0.006 inches with thetotal thickness of the staple 54 being approximately 0.015 inches withapproximately 0.005 inches of the staple residing in the slot 120, 122,approximately 0.005 inches of the staple residing in and supported bythe staple holding location 92 of the first plate 82 and approximately0.005 inches of the staple residing in and supported by the stapleholding location 124 of the third plate 86. FIG. 22 illustrates thestandard arrangement in which two rows of staggered staple pockets 118are located on either side of the slider I-beam 32 blade 42 fordelivering a total of four lines of staggered staples 54. In anothervariation, the staple cartridge 52 is configured to include anadditional fourth plate (not shown) sandwiched together for creating athird row of staples pockets 118 on either side of the blade 42 for atotal of six rows of staggered staples 54. Any number of staple rows iswithin the scope of the present invention achieved by the addingadditional plates.

Turning now to FIGS. 23-25, in one variation of the invention, anasymmetrical staple cartridge is provided. The asymmetrical staplecartridge utilizes a different number of rows of staple pockets oneither side of the I-beam 32 blade 42. In one variation, the staplecartridge includes two or three rows of staple pockets on one side ofthe I-beam 32 blade 42 and only one row of staple pockets on the otherside of the I-beam 32 blade 42 creating a total of three or four rows ofstaples with one row of staples delivered on one side of the cuttingline. The staple cartridge may be a single unitary piece or be comprisedof two cartridges, one having two or three rows of staple pockets fordelivering two or three rows of staples placed on one side of the blade42 and a second staple cartridge having only one row of staple pocketsfor delivering only one row of staples on the other side of the blade42. The asymmetric stapler advantageously results in a smaller devicewith a decreased diameter of the end effector 18. Alternatively, thesaved space in the end effector 18 can be utilized to advantageouslyprovide additional structural support in a device of the same diameter.While two to three rows of staples on both sides of the blade 42 may bepreferred for holding living tissue, a specimen to be removed may onlyrequire one row of staples on one side of the cutting line designed forshort term holding onto tissue to be removed. The resulting smallerdevice diameter would be beneficial in certain procedures such as in theremoval of an endoluminal polyp. In such a procedure, the endoluminalpolyp removal stapler would have two or three rows of staples on oneside of the blade for delivering two or three rows of staples into thecolon side of the cutting line and one row of staples for delivering onerow of staples into the polyp side of the cutting line. Through the useof different number of staple rows on either side of the cutting line,the staplers can be tailored to their specific surgical applications.The result is a dramatic reduction in instrument size, in particular,the diameter of the end effector 18, or alternatively an instrument withof same size but having increased instrument strength and reliability.FIG. 23 illustrates the resulting cut employing an asymmetrical stapleraccording to the present invention. FIG. 23 shows three lines 132 ofstaggered staples delivered into the organ side 134 and one line ofstaples 136 delivered into the removed tissue 138. In order to provideto the surgeon user visual indication as to which side of the stapler 10delivers fewer rows, the end effector 18 of the stapler 10 is colorcoded such that the side of the stapler 10 that has fewer rows ofstaples is colored a different color from the side of the stapler thathas two or more rows of staples as shown in FIG. 24. For example, theside of the stapler with a single line of staples is colored red and theother side of the blade is colored green. Other markings on the stapler10 are possible. In another variation shown in FIG. 25, the end effector18 of the stapler is curved such that the surgeon knows to place theconcave portion of the curvature against or on the side of the polyp138, for example, and the convex side of the curved end effector againstthe colon side 134. The curved jaws assist the surgeon user in denotingproper orientation of the stapler with the concave side of the curvaturehaving few rows of staples compared with the concave side of the bladewhich has a greater number of rows of staples. In another variation, theconcave side of the stapler blade includes fewer rows of staplesrelative to the convex side of the stapler blade.

Turning now to FIGS. 26-30, the slider 56 will be described. The slider56 includes a slider base 140 having a bottom surface 142 and a topsurface 144. At least a portion of the bottom surface 142 toward thedistal end is curved to conform to the curved bottom 74 of the lower jaw50. At the proximal end of the slider 56, the bottom surface 142includes a recessed portion 146 sized and configured to receive thebottom portion 36 of the I-beam 32. A slot 148 is formed in the sliderbase 140 that opens at the proximal end and extends toward the distalend of the slider base 140. The slot 148 is sized and configured toreceive at least the lower middle portion 38 of the I-beam 32. In onevariation, the front end of the slider 56 that leads distal translationincludes a beveled or angled front surface to assist in urging staplesfrom the device. Upstanding from the top surface 144 of the slider base140 are at least two angled caming surfaces 150. FIGS. 26-30 depict aslider 56 that includes four upstanding angled caming surfaces 150 a,150 b, 150 c, 150 d. An asymmetrical staple cartridge according to thepresent invention will have a slider 56 that corresponds to the numberof staple rows on each side of the I-beam blade 42. Two angled camingsurfaces 150 a, 150 b are separated by an I-beam receiving portion 152from the two angled caming surfaces 150 c, 150 d. The I-beam receivingportion 152 is sized and configured to receive the middle portion 38 ofthe I-beam 32. Each caming surface 150 is approximately 0.005 inchesthick and includes an angled distal end. The angle of the caming surface150 corresponds to the angle of the staple holding locations 92 and 124which ranges from approximately 30-90 degrees wherein 90 degrees is avertical caming surface 150. The slider 56 is disposed inside the lowerjaw 50 inside a lower passageway defined between the one or more staplecartridges 52 and the bottom cover 74. The slider 56 is retained in thelower jaw 50 between the one or more staple cartridges 52 and bottomcover 74 yet the slider 56 is free to translate longitudinally distallyand proximally with respect to the lower jaw 50. The upwardly extendingcaming surfaces 150 a and 150 b extend upwardly through slots 120 and122, respectively, of the staple cartridge 52 on one side of the blade42 of the I-beam 32. The other two upwardly extending caming surfaces150 c and 150 d extend upwardly through slots 120 and 122, respectively,of the other side of the staple cartridge 52 or second staple cartridge52 on the other side of the blade 42 of the I-beam 32. The slider camingsurfaces 150 are configured to contact staples residing inside staplepockets 118 and sequentially urge them out towards the anvil surface 58of the upper jaw 48 as the slider 56 translates along the end effector18.

Turning now to FIGS. 31-34, a staple 54 according to the presentinvention will be described. The staple 54 is shown in its undeformed oropen condition. The staple 54 includes a first leg 154 and a second leg156 interconnected by a base 158. The first leg 154 intersects with thebase 158 at approximately 90 degrees and defines a first intersection160. The second leg 156 intersects with the base 158 at approximately 90degrees and defines a second intersection 162. The first leg 154 islonger than the second leg 156. The staple 54 includes an inner surface164 and an outer surface 166 interconnected by a first sidewall 168 andsecond sidewall 170. The inner surface 164 intersects with the outersurface 166 at a first point 172 at the first leg 154 and at a secondpoint 174 at the second leg 156. The first point 172 and second point174 are line intersections in FIG. 31 that are perpendicular to thelength of the staple 54. In another variation, the line intersectionsare parallel to the length of the staple 54. In another variation, thefirst point 172 and/or the second point 174 are point intersections. Inanother variation, the first point 172 and/or second point 174 areplanar surfaces or any other geometric shape that is suitable forpuncturing and penetrating tissue through which the staple is delivered.The first leg 154 includes a first tip 176 at the free distal end of thefirst leg 154 and the second leg 156 includes a second tip 178 at thefree distal end of the second leg 156. The first and second tips 176,178 begin where the first and second legs 154, 156, respectively, beginto taper or decrease in cross-sectional area in the direction distallyalong the leg 154, 156.

With particular attention to FIGS. 32-34, the first leg 154 isapproximately 0.097 inches long and the second leg 156 is approximately0.050 inches long. The ratio of the shorter second leg 156 to the longerfirst leg 154 is approximately ½. The overall length of the base 158 isapproximately 0.080 inches and each leg 154, 156 is perpendicular to thebase 158. The radius of curvature of the outer surface 166 at the firstand second intersections 160, 162 is approximately 0.009 inches. Thedistance between the first sidewall 168 and the second sidewall 170 orthickness of the staple is approximately 0.015 inches. The distancebetween the inner surface 164 and the outer surface 166 or width of thefirst and second legs 154, 156 is approximately 0.010 inches. Thedistance between the inner surface 164 and the outer surface 166 orwidth of the base 158 is also approximately 0.010 inches. The first tip176 includes a curved outer surface 166 having a radius of curvature ofapproximately 0.034 inches. This curve forms a concave outer surface 166in the location of the first tip 176. The inner surface 164 at the firsttip 176 is perpendicular to the base 158 and intersects with the curvedouter surface 166 at a line intersection defining the first point 172.The second tip 178 includes an angled outer surface 166. The portion ofthe outer surface 166 in the location of the second tip 178 is angledapproximately 10 degrees from vertical towards the inner surface 164.The portion of the inner surface 164 in the location of the second tip178 is angled approximately 30 degrees from vertical towards the outersurface 166. Together the angled outer surface 166 and the angled innersurface 164 in the location of the second tip 178 form an angle ofapproximately 40 degrees therebetween and define a line intersection atthe second point 174.

With particular attention to FIGS. 35-37, the staple 54 is shown in itsdeformed or closed configuration in which the first leg 154 is angledtowards the second leg 156 to form a triangular shape or delta orD-shaped configuration. The triangular shape results when the first leg154 is deformed as a result of urging the undeformed staple 54 fromstaple pockets 118 in the lower jaw 50 against the anvil surface 58 ofthe upper jaw 48 of the stapler 10 of the present invention. In thisdelta configuration, the second leg 156 remains upstanding andsubstantially perpendicular to the base 158 and the first leg 154 isdeflected to towards the second leg 156 until the first and second tips176, 178 meet or are substantially in juxtaposition to each other. Theresulting angle of the deflected first leg 154 with respect to the base158 is approximately 29 degrees. In one variation, the staple has acircular cross-section. In another variation of the staple 54, a stressconcentration is formed in the first leg 154 to create a weaker locationin the first leg 154 so that deformation, bending or deflection of thefirst leg 154 takes place in the location of the stress concentration.An example of a stress concentration is at least one notch formed in theinner surface 164 at a location along the first leg 154 to encouragebending of the first leg 154 to occur at the stress concentration. Anexample of stress concentration in the form of a notch 188 is shown inFIGS. 44A and 44B. In another variation, stress concentrations such asone or more notches are strategically placed to effect a variety ofclosed staple shapes. For example, closed staple shapes are not limitedto a triangular shaped staple but also include rectangular, square,rhombus, and trapezoid shapes. Furthermore, in another variation,notches are formed to capture one leg inside the notch formed in theopposite staple leg to create a locking variant in which the closedstaple shape includes interlocked first and second legs configuredresist forces that would open the staple from a closed and interlockedconfiguration.

Turning to FIGS. 38-39, the staple 54 is shown to include at least onebarb 180. In the variation shown in FIG. 38, a single barb 180 isprovided near the distal end of each leg 154, 156 formed in the innersurface 164 of the staple 54. Barbs assist in providing an increasedmechanical hold of the staple into tissue and can be formed on either orboth legs and on the inner surface 164 or outer surface 166. Multiplebarbs 180 along one of the legs are shown in FIG. 39. In FIG. 39, fourbarbs 180 are formed in the inner surface of the first leg 154 and onebarb 180 is formed in the inner surface of the second leg 156. Smallerbarbs 180 such as micro and nano sized barbs are also within the scopeof the present invention.

Turning now to FIGS. 40-41, there is shown a four-pronged staple 182.The four-pronged staple 182 includes a longer first leg 154 ainterconnected to a shorter second leg 156 a by a base 158 a and asecond longer first leg 154 b interconnected to a shorter second leg 156b by a base 158 b. Each pair of staple legs 154 a, 156 a and 154 b, 156b and their interconnected bases 158 a, 158 b are substantiallyidentical to the staple 54 depicted and described with respect to FIGS.31-37, except in the four-pronged staple 182 the two pairs of legs areinterconnected by a enlarged base portion 184 that has the samethickness as staple bases 158 a, 158 b which are approximately 0.010inches thick. The enlarged base portion 184 is connected to base 158 aand base 158 b and serves as a caming surface for engagement with aslider 56 that includes an enlarged angled slider caming surface 186.The staple cartridge 52 is still formed in a similar manner as describedwith respect to FIGS. 17-22 except that it is adapted to receive a widerstaple having wider slots 120, 122 to accommodate the wider four-prongedstaple 182 and wider slider 56. The cartridge 52 adapted for thefour-pronged staple 182 is preferably similar to that described withrespect to FIG. 22 in which the first plate 82 and second plate 84include oppositely formed angled staple holding locations 92, 124,respectively. At least a portion of the first leg 154 a, second leg 156a and base 158 a is disposed in the staple holding location 92 of thefirst plate 82 and at least a portion of the first leg 154 b, second leg156 b and base 158 b is disposed in the staple holding location 124 ofthe second plate 84. An additional third plate 86 may hold another rowof four-pronged staples 182 between the third plate 86 and second plate84 as described above with another slider caming surface 186 residing inthe second slot 122. The four-pronged staples 182 are angled to matchthe angle of the slider 56 caming surface 186 such that when the slider56 is pushed forward by the translating I-beam 32, the angled slidercaming surface 186 contacts the enlarged base portion 184 of the staple182 to urge the staple 182 upwardly and out of the cartridge 52 andagainst the anvil surface 58 of the upper jaw 48 where the staple 182 isdeformed into tissue. The deformed staple includes two triangular shapedclosures wherein the first legs 154 a, 154 b are bent towards the secondlegs 156 a, 156 b, respectively.

FIGS. 42A-42D illustrate various views of a four-pronged staple 182 thatincludes an even larger base portion 184 to provide additional strengthto the staple 182. The first and second tips 176 a, 176 b, 178 a, 178 binclude angled first and second sidewalls 168 a, 168 b, 170 a, 170 b toform line intersections that are parallel to the length of the staple182. A four-pronged staple 182 having flat, blunt first tips 176 a, 176b and second tips 178 a, 178 b are shown in FIG. 43A. The four-prongedstaple 182 of FIG. 43A may be cut along dotted lines to form two singlestaples 54 having only two legs 154, 156 each with flat first and secondtips 176, 178 as shown in FIG. 43B.

Turning now to FIGS. 44A-44D, there is shown a four-pronged staple 182having notches 188 formed in the inner surface of first legs 154 a, 154b. The notches 188 are curved semi-cylindrically shaped indentationsthat create stress concentrations in the legs 154 a, 154 b such thatwhile being deformed the legs 154 a, 154 b will tend to bend in thelocation of the notches 188. In the variation of the four-pronged staple182 of FIGS. 44A-44D, the first tips 176 a, 176 b include curved outersurfaces 166 a, 166 b intersecting with straight inner surfaces 164 a,164 b to form line intersections that are perpendicular to the length ofthe staple 182. The second tips 178 a, 178 b are formed by angled outersurfaces 166 a, 166 b intersecting with straight inner surfaces 164 a,164 b to form line intersections that are perpendicular to the length ofthe staple 182. When deformed, the first legs 154 a, 154 b are bent atthe notches 188 such that first tips 176 a, 176 b contact second tips178 a, 178 b to form two connected triangular shaped closures.

With reference to FIGS. 45A-45D, a four-pronged staple 190 havingstaggered legs is shown. A first two-pronged staple having a longerfirst leg 154 a interconnected to a shorter second leg 156 a by a base158 a is connected via an angled enlarged planar base portion 184 to asecond two-pronged staple having a longer first leg 154 b interconnectedto a shorter second leg 156 b by a base 158 b such that the firsttwo-pronged staple is offset or staggered with respect to the secondtwo-pronged staple. The first and second two pronged staples aresubstantially identical to the staple described above with respect toFIGS. 31-37. The angled base portion 184 interconnecting the twotwo-pronged staples allows the first two-pronged staple to be offsetfrom the second two-pronged staple resulting in a four-pronged staple190 with staggered legs 154 a, 154 b, 156 a, 156 b. The enlarged baseportion 184 serves as a caming surface for caming against the angledcaming surface 150 of the slider 56. When actuated the two longer firstlegs 154 a, 154 b are deformed against the anvil surface 58 towards thesecond legs 156 a, 156 b, respectively, to form two triangular shapedclosures capturing tissue therebetween. When an entire row offour-pronged staples 190 are deployed, the result is two effective rowsof staggered staples.

Turning now to FIGS. 46A-46D, there is shown a six-pronged staple 192.The six-pronged staple 192 includes a first two-pronged staple 194connected to a second two-pronged staple 196 connected to a thirdtwo-pronged staple 198 in a staggered fashion. The first, second andthird two-pronged staples 194, 196, 198 are substantially identical tothe two pronged staple 54 of FIGS. 31-37 described above. The firsttwo-pronged staple 194 includes a longer first leg 154 a interconnectedto a shorter second leg 156 a by a base 158 a. The second two-prongedstaple 196 includes a longer first leg 154 b interconnected to a shortersecond leg 156 b by a base 158 b. The third two-pronged staple 196includes a longer first leg 154 c interconnected to a shorter second leg156 c by a base 158 c. Each of the two-pronged staples 194, 196, 198 isconnected to each other at their bases 158 a, 158 b, 158 c,respectively. The first two-pronged staple 194 is connected to thesecond two-pronged staple 196 by an angled extended base portiontherebetween such that the first two-pronged staple 194 is offset fromthe second two-pronged staple 196. The second two-pronged staple 196 isconnected to the third two-pronged staple 198 by an angled extended baseportion therebetween such that the second two-pronged staple 196 isoffset from the third two-pronged staple 198. The three two-prongedstaples 194, 196, 198 are connected such that the first and thirdtwo-pronged staples 194, 198 are in alignment with respect to each otherand the middle second two-pronged staple 196 is offset relative to thefirst and third two-pronged staples 194, 198. The six-pronged staple 192is loaded in an angled manner into a cartridge as described above withrespect to FIGS. 22, and 40-41 wherein the first two-pronged staple 194is disposed at least in part into a staple holding location 92 of thefirst plate 82 and the third two-pronged staple 198 is disposed at leastin part into a staple holding location 124 of the second plate 84 suchthat the middle or second two-pronged staple 196 resides inside thefirst slot 120 together with a slider 56 having an enlarged camingsurface 186 of the like described with respect to FIGS. 40-41 againstwhich the base portions engage for deployment. Of course a third-plate86 with staple holding locations 92 is loaded with staples 192 in thesame manner for engagement with a second slider 56 residing inside thesecond slot 122. After the six-pronged staple 192 is urged by the slideragainst the anvil surface 58, the first legs 154 a, 154 b, 154 c aredeflected towards the second legs 156 a, 156 b, 156 c, respectively, toform three triangular shaped closures that capture tissue. These threetriangular shaped closures are staggered with respect to each other yetinterconnected to form a wide and strong stapling of tissue.

Referring now to FIGS. 47A-47C, another staple variation is shown. Inthis variation, the staple 204 includes a first leg 154 interconnectedto a second leg 156 by a base 158. The first leg 154 is substantiallystraight when undeformed and includes a first tip 176 having an angledor chamfered outer surface. The second leg 156 is slightly longer thanthe first leg 154. The second leg 156 also includes an elbow 206 atwhich the second leg 156 is bent slightly towards the first leg 154while in the undeformed condition as shown in FIGS. 47A-47B. The secondleg 156 includes a second tip 178 which in one variation commences totaper from the elbow 206. Since the staple 204 is disposed inside acartridge at an angle as described above, when the staple 204 is urgedupwardly by an advancing slider (not shown), both the first and secondtips 176 and 178 contact the flat anvil surface 58 substantiallysimultaneously as shown in FIG. 47B. Continued urging of the staple 204into the anvil surface 58 results in the first leg 154 bending towardsthe second leg 156 and the second leg 156 bending towards the first leg154 as shown in FIG. 47C. The angled or chamfered outer surface at thefirst tip 176 assists in directing the first leg 154 towards the secondleg 156. The elbow 206 and angled second leg 156 assist in directing thesecond leg 156 towards the first leg 154. Because the staple pockets 118retain the staples 204 at an angle to the flat anvil surface 58, thesecond leg 156 has to be slightly longer and angled such that theportion of the second leg 156 that is distal to the elbow 206 issubstantially perpendicular to the flat anvil surface 58 when the secondtip 178 contacts the flat anvil surface 58. This variationadvantageously does not require anvil pockets formed in the anvilsurface and precise alignment of the staple legs 154, 156 with anvilpockets to effect deflection of staple legs 154, 156 towards each other.Such deflection is accomplished against a flat anvil surface 58.

With reference to FIG. 48, there is shown a plurality of staples 54connected to a backbone 200 illustrating the formation of staples 54 ina fishbone style for ease of manufacturing, assembly and handling. Asheet of metal such as surgical steel, stainless steel, or titanium isprovided and a plurality of staples 54 is cut into the sheet of metal ona wire electrical discharge machining (EDM) machine. The staples 54 mayalso be formed utilizing a micro-water jet, photo etching or bystamping. The staples 54 remain connected to the backbone 200 via narrowconnecting tabs 202 until the staples 54 are broken off at the tabs 202and then loaded into a staple cartridge. After a staple 54 is broken offa portion of the connecting tab 202 remains attached to the staple 54.The remnant tab 202 serves as a barb 180 for increasing mechanicalholding onto tissue captured inside a closed staple 54 after deployment.Therefore, the staple 54 is manufactured without the need forpost-processing such as bending and sharpening. Also, the backbone 200can be an aid in the storage of staples 54 and in the assembly of staplecartridges.

Turning to FIGS. 49-50, a staple cartridge 52 in the form of a singleunit is inserted into the staple cartridge receiving portion 72 of thelower jaw 50. The staple cartridge 52 may also be in the form of twounits 52 a, 52 b with each unit having two slots 120, 122 with two rowsof staples 54 residing inside staple pockets 118. An asymmetricalcartridge as described above can also be employed. The staple cartridge52 is inserted such that the grooves 104, 108, 116 of first, second andthird plates 82, 84, 86, respectively, engage the tongue 78 at theproximal end of the lower jaw 50 and the tongues 102, 106, 114 of thefirst, second and third plates 82, 84, 86, respectively, engage theledge 76 at the distal end of the lower jaw 50. A cartridge retainer 80is connected covering the tongues 102, 106, 114 as shown in FIG. 50 tosecure the cartridge in position. Each cartridge 52 can include a coverslip of paper (not shown) covering the staple pockets 118 to retain thestaples 54 inside the pockets 118 during storage and handling. The coverslip is then removed by peeling away just prior to or after installationof the cartridge 52. Each cartridge 52 also contains a slider 56disposed inside the cartridge 52 such that the angled caming surfaces150 a, 150 b of the slider 56 reside in slots 120, 122, respectively onone side of the I-beam receiving portion 152 and the angled camingsurfaces 150 c, 150 d of the slider 56 reside in slots 120, 122,respectively on the other side of the I-beam receiving portion 152. Oneside of the cartridge 52 a is spaced apart from the other side of thecartridge 52 b to create a central passageway 208 to allow passage ofthe translating I-beam 32.

Another variation of cartridge 52 installation is shown in FIGS. 51-52.In this variation, the front or distal end of the lower jaw 50 is openand the cartridge 52 includes rails 212 that engage tracks 210 formed inthe staple cartridge receiving portion 72 of the lower jaw 50. Thecartridge 52 slides in through the open distal end of the lower jaw 50which is then closed with a cap or latch (not shown). The cartridge 52is shown to include a top plate 214 which increases the strength acrossthe width of the device. After the staples 54 are expended, the staplecartridge 52 can be removed and disposed and a new cartridge insertedfor continued stapling. In another variation, the staple cartridge 52 ispre-installed inside the stapler cartridge assembly 14 and after thestaples 54 are expended the entire stapler cartridge assembly 14 isremoved and disposed and a new stapler cartridge assembly 14 isconnected to the handle assembly 12 for continue stapling.

With the stapler cartridge assembly 14 connected to the handle assembly12, the actuator shaft 22 connects to the actuator shaft 216 inside thehandle assembly 12. The handle assembly 12 is then used to operate thestapler 10 in three different functions or modes of operation. The firstmode allows the user to open and close the jaws 48, 50 of the endeffector 18. The second mode fires the staples and the third mode ofoperation returns the I-beam 32 to its original proximal positionfollowing the firing of staples.

With reference to FIG. 53, the handle 218 is connected to a forwarddriver 220 which engages a forward tooth on the actuator shaft 216. Whenthe handle 218 is depressed, the actuator 216 is moved slightly forwardwhich in turn moves the actuator shaft 22 of the stapler cartridgeassembly 14 forward. Since the actuator shaft 22 is connected to theI-beam 32, the I-beam 32 advances forward with the depression of thehandle 218. As the I-beam 32 advances, the beveled front end 40 of thetop portion 34 of the I-beam 32 enters the passageway 64 in the upperjaw 48 which deflects the open and spring biased upper jaw 48 downwardfrom an open position to a closed position as shown in FIGS. 54-55. Theupper jaw 48 is connected to the lower jaw 50 with a pin such that theupper jaw 48 pivots with respect to the lower jaw 50. Springs (notshown) are included to create a spring bias that urges the upper jaw 48in an open position with respect to the lower jaw 50. The top portion 34of the I-beam 32 is shown entering the passageway 64 in FIG. 54 with thejaws biased in an open position. In FIG. 55, the top portion 34 of theI-beam 32 has entered the passageway 64 and moved the upper jaw 48 intoa closed orientation with respect to the lower jaw 50. When the handle218 is released the actuator shafts 216, 22 move proximally pulling theI-beam 32 also proximally allowing the spring bias to open the jaws asthe top portion 34 exits the passageway 64. The user can open and closethe jaws of the end effector 18 by pressing and releasing the handle 218to position the targeted tissue between the upper and lower jaws ofstapler 10. The end effector 18 is shown in an open position in FIG. 56and in a closed position in FIG. 57 in which the distance across the gapbetween the upper jaw 48 and lower jaw 50 is approximately 0.040 incheswhen in the closed position.

After the jaws are closed in position at the targeted tissue location,the stapler 10 is switched to operate in fire mode by depressing a firebutton 224 on the handle assembly 12 as shown in FIG. 58. The firebutton 224 disengages an open driver 226 from the actuator shaft 216 asshown in FIGS. 59-60 freeing it for longitudinal movement. The opendriver 226 is shown engaged with the teeth of the actuator shaft 216 inFIG. 60. In FIG. 59, the open driver 226 is shown disengaged from theteeth of the actuator shaft 216 with the fire button 224 depressed. Withthe open driver 226 disengaged, the trigger handle 218 swings out andthe forward driver 220 engages with forward teeth on the actuator 216.Depressing the handle 218 advances the actuator shaft 216 forward as theforward driver 220 freely engages teeth with each squeeze of the triggerhandle 218. The handle 218 is squeezed multiple times to advance theI-beam 32 all the way to the distal end of the cartridge 52. The handleassembly 14 may also include a rotatable rack described in co-pendingU.S. Provisional Patent Application entitled “Surgical stapler havingactuation mechanism with rotatable shaft” incorporated herein byreference in its entirety.

Turning now to FIG. 61, there is shown the end effector 18 with the jaws48, 50 in a closed position. As the I-beam 32 is advanced distally, thetop portion 34 of the I-beam 32 travels in the upper passageway 64 andthe bottom portion 36 of the I-beam 32 enters the slot 148 of the slider56 engaging with the slider 56 and pushing it distally. As the angledcaming surface 150 leads, it contacts staples (not shown) to urge themout of staple holding locations 92. The blade 42 of the I-beam 32resides in the gap 228 between the upper jaw 48 and the lower jaw 50cutting tissue captured between the jaws in between tissue resolved withtwo or more rows of staples on either side of the blade 42.

FIGS. 62-63 illustrate the deployment of staples 54 as the slider 56 andI-beam 32 advance in the distal direction. The staples 54 are disposedinside staple pockets 118 such that at least a portion of the staple 54rests against U-shaped staple holding locations 92 such that the longerfirst leg 154 is located proximally relative to the shorter second leg156. As the slider 56 advances, the angled caming surfaces 150sequentially contact the staples. In one variation, a beveled front end230 of the slider 56 contacts that portion of the outer surface 166 ofthe staple 54 such as the base 158 of the staple 54 that is in the gap100 in the bottom wall 98 of the U-shaped staple holding location 92 andurges the staple 54 upwardly. As the slider 56 advances the angledcaming surfaces 150 of the slider 56 contact the staples 54 and continueto urge them sequentially upwardly with distal translation of the slider56. With sufficient deployment height, the longer first leg 154 of thestaple 54 contacts the flat anvil surface 58 of the upper jaw 48. Inparticular, the first tip 176 contacts the flat anvil surface 58.Because the first tip 176 includes a curved, chamfered or beveled outersurface 166, contact of this curved outer surface with the flat anvilsurface 58 assists in bending the first leg 154 towards the second leg156. The curved outer surface 166 of the first tip 176 slides againstthe flat anvil surface 58 as the first leg 154 bends into a closedtriangular configuration. The shorter second leg 156 is not bent ordeformed. Unlike a conventional staple, which is fired with the staplelegs perpendicular to the forming anvil, the staple of the presentinvention is fired at an angle with respect to a flat anvil surface 58.There are no staple forming pockets in the anvil surface of the presentinvention. As the long leg 154 contacts the flat anvil surface 58, thetip 176 of the long leg 154 slides freely along the anvil surface whilethe staple 54 is progressively pushed normal to the staple base 158because the staple is at the same angle as the angled caming surface 150of the slider 56 until the tip 176 of the long leg 154 meets the tip ofthe shorter second leg 156 and the staple is closed capturing tissueinside the triangular shaped closure. The closure force of the staple 54of the present invention is advantageously relatively low when comparedto conventional staples because only one leg is being deformed, thelonger first leg 154; whereas, in conventional staplers, both legs of astaple are deformed simultaneously. Furthermore, closure forces arefurther reduced by the fact that the long leg is simply being bent overas opposed to being forced to buckle against an anvil pocket. Bucklingforces of a beam are much greater than bending forces and conventionalstaples require the buckling of two staple legs simultaneously.Conventional stapling devices require high firing forces to apply thestaple lines. The staple legs are forced perpendicular to the anvilpockets forcing them to buckle. These high forces apply significantstresses to the device components and can cause fatigue for the user.Therefore, the present stapler 10 greatly reduces forces required todeploy and deform staples. The staple forming forces of the presentinvention are relatively low when compared with conventional stapledesigns. Since only a single leg bends over in contact with the anvilsurface, the user and device is benefited through reduced stresses onthe components and reduced actuation forces for the user.

The staple deployment method of the present invention drives a slantedslider down the jaws of the stapling device. The slider 56 comes indirect contact with the staples 54 as it passes through the same spaceas the staples being deployed. The staples are partially held in placeby pockets 118 in the interior jaws or cartridge 52 of the device. Thesepockets provide guidance for the staples as they are pushed out of thedevice and formed into tissue. The staples are held in the cartridge insuch a way that only part of the staple thickness is resting in a pocketwhile the other part is in an open channel that is coplanar with theslider 56. One side of the staple is held against the first plate insidestaple receiving locations 92 while the other side of the staple is heldagainst the smooth wall of the second plate or, alternatively, in stapleholding locations 124 also formed in the second plate. Each slidercaming surface 150 travels down the center of the staple in each slot120, 122. As the slider 56 is pushed distally along the length of thejaw, the angled slider ramp drives the staples out of the guidedcartridge pockets. The angled caming surface 150 of the slider pushesnormal to the staple base 158. The slider only contacts a part of thestaple, while the remaining part of the staple is held against thestaple holding locations 92 which serve as guides directing the stapleout of the cartridge.

Turning now to FIGS. 64-65, after the staples are fired, the handleassembly 12 is switched into the third mode of operation in which theI-beam 32 is returned proximally to its starting position. A gear switchbutton 232 is depressed which rotates the actuator shaft 216 90 degreesso that the reverse teeth on the actuator 216 come into contact with thereverse driver 234. The reverse driver 234 is connected to the handle218 by a series of gears. When the handle 218 is squeezed, the reversedriver 234 pulls the actuator 216 and I-beam 32 back. The trigger handle218 is squeezed multiple times to return the I-beam 32 to its originalposition. The I-beam 32 is returned to its original proximal position toopen the jaws 48, 50. With the I-beam 32 returned, the slider 56 is leftin its distal fired position. FIG. 66 illustrates, the I-beam 32returned and fully retracted resulting in the spring biased upper jaw 48becoming open while the slider 56 is left in its distal locationallowing the stapled tissue to be released from the jaws. When theactuator 216 and I-beam 32 is returned, the stapler cartridge assembly14 can be detached from the handle assembly 12 and new stapler cartridgeassembly 14 can be attached to continue stapling.

The conventional laparoscopic stapler is currently approximately 12millimeters in diameter which requires a larger sized cannula forinsertion and, hence, a larger incision in the patient. The laparoscopicstapler 10 of the present invention has a diameter of approximately0.271 inches as shown in FIG. 67 which will advantageously fit insidesmaller diameter cannulas that require smaller incisions in the patient.The smaller incision results in less pain, faster patient recovery timesand a smaller scar visible after the operation. FIG. 67 illustrates thatthe I-beam 32 substantially defines the diameter of the end effector 18.Approximately a little less than half the diameter of the device isconsumed with the upper jaw and gap between the upper and lower jawleaving approximately half the diameter of the device, approximately0.130 inches for housing the staples and mechanisms for stapledeployment including the slider.

The problem presented in traditional staplers is that they requirelarger diameters and larger incisions as well as higher firing forces inorder to deploy staples. This is due to the fact that traditionalstaples require a pusher to deploy staples. The pusher is anintermediate caming surface disposed between each staple and the slider.Typically, each pusher is of equal height as the staple and residesdirectly below the staple. The height of the pusher has to beapproximately equal to the height of the staple in order to fully urgethe staple out of the staple pockets and into the gap between the upperand lower jaws. The pusher typically includes an angled lower surfacethat cams against an angled slider. The upper surface of the pusher istypically flat and horizontal and cams normal to the base of the staple.In essence, the pusher takes up valuable space when trying to achieve asmaller stapler that will fit in a smaller sized cannula which istypically called a 5 millimeter cannula. The present inventionsuccessfully eliminates the pusher altogether due to the angledpositioning of the staple such that the base of the staple is parallelto the angled caming surface of the slider. Because the staple of thepresent invention is placed at an angle, the horizontally travelingslider comes in direct contact with the staple during deployment withouthaving any additional pusher between the staple and slider. Becausethere is no pusher required in the present invention, a great deal ofspace is saved resulting in a much smaller diameter device.

It is not just a matter of reducing staple size but also effectivelydeploying staples that form a closed staple configuration capable ofholding tissue in a manner that is just as strong as a conventionalstapler and doing so in a reliable and repeatable manner that is animportant factor achieved by the stapler of the present invention.Another problem of conventional staplers that the present inventionaddresses and successfully avoids pertains to the anvil surface.Traditional anvil surfaces include detailed anvil pockets formed in theanvil surface. These anvil surface formations are necessary in order toreliably and repeatedly form staples in conventional staplers. The anvilsurface is especially important as traditional staples are placed normalto the anvil surface and without anvil surface formations to guide thebuckling staple legs the staple legs would splay in any direction andnot form a nice closure important for securing tissue. Furthermore, theanvil pockets of traditional staplers require that the anvil of theupper jaw be perfectly aligned with the staple pockets and inparticular, the staples residing in the pockets in order to effectperfect staple formation. Anvil surface formations or pockets are anecessity for staple formation reliability; however, they also increasemanufacturing costs that result from not only forming detailed surfaceformation but also in making sure the anvil surface formations are inalignment with the staple trajectory. The present inventionadvantageously eliminates anvil surface formations and provides asmooth, flat anvil surface against which the staple legs are deformed.Typically, without anvil surface formations the staple legs would splayin any direction and not form a perfect closure. However, the presentinvention provides for angled staple holding locations that hold thestaple at an angle with respect to the anvil surface. Furthermore, thestaple has one longer leg and a shorter leg. As a result of this design,as the staple is ejected from the lower jaw, it is the longer leg thatleads staple ejection. Because the longer leg leads, this leg will bethe first leg to contact the anvil surface and instead of splaying inany direction the first leg is reliably bent towards the second leg.Misalignment of staple tips is eliminated because as the longer leg isbeing deformed against the flat anvil surface the remaining portion ofthe staple including the shorter leg remains substantially contained andguided in the staple pocket or staple holding location and preventedfrom lateral displacement that would result in a malformed staple. Also,the tip of the longer leg is curved or chamfered which provides apredilection for the staple to bend towards the second leg. Also, thecurved tip allows the tip of the longer leg to slide against the smoothanvil surface as the longer leg of the staple is being deformed. Hence,the present invention not only reduces the overall diameter of the endeffector, it also does so without sacrificing staple formationrepeatability and reliability.

The problem of fitting a surgical stapler into a 5 mm cannula is solvedby the absence of intermediate caming portions that are also known as“pushers” located between the slider and the staple. Typically, the legsof a staple are located in receiving pockets such that they areperpendicular to the anvil. The angled slider contacts the pushers whichthen contact the staple to drive it out of the staple pocket. Without anintermediate caming portion or pusher, the slider would have to contactthe staple directly risking angular forces upon the staple that wouldangulate the staple legs out of alignment with the anvil surfaceformations resulting in malformed staples or angulate the staple legswith respect to the pocket resulting in the staple jamming against thepocket. Typically, the staples are stacked above the pushers. Therefore,removal of pushers saves tremendous space in the design and angledstaples contact an angled slider directly. The elimination of pushersalso further reduces manufacturing costs as the number of components isreduced and eases manufacturing as pushers are no longer required to beassembled. The angled orientation of the staples themselves is also atremendous space saver as opposed to the staples being verticallyoriented as in traditional staplers. Since there is no target pocket oranvil surface formation for the staple legs to come into contact with,the reliability of staple formation is greatly improved as the staple isfree to deform against a smooth anvil surface without riskingmisalignment with anvil pockets as in traditional staplers. Valuablespace is also saved by the slider moving through the same space or slotsin which the staples reside.

Turning now to FIG. 68, there is shown another variation of a staplecartridge 52 similar to that described above with respect to FIGS. 17-21wherein like numbers are used to describe like parts. As describedabove, the cartridge 52 comprises at least two plates sandwichedtogether to form a single row of staple receiving pockets withadditional plates added to increase the desired number of staple rows.The outer surface 88 of the first plate 82 is smooth and the innersurface 90 is formed with a plurality of staple holding locations 92.The staple holding locations 92 are recesses formed in the inner surface90 of the first plate 82. Each staple holding location 92 issubstantially U-shaped and defined by a front sidewall 94 formedoppositely and substantially parallel to a rear sidewall 96. The rearsidewall 96 is interconnected to a bottom wall 98 forming an L-shapedwall defining a gap 100 between the bottom wall 98 and the frontsidewall 94. In one variation, no gap 100 is formed. Instead, the bottomwall 98 interconnects with both the front sidewall 94 and rear sidewall96 to form a complete U-shaped staple holding location 92. The U-shapedstaple holding locations are angled approximately 30-90 degrees with 90degrees being a vertical non-angled orientation. FIG. 68 illustrates theU-shaped staple holding location being at 90 degrees or substantiallyperpendicular. The recessed wall 99 is recessed with respect to theinner surface 90. Segments of the inner surface 90 that are locatedbetween the staple holding locations 92 include a plurality ofhorizontal grooves 236 that extend between the staple receivinglocations 92. The grooves 236 are rectangular and have square orrectangular cross-sections. The grooves 236 have a depth equal to thedepth of the recessed wall 99. The grooves 236 are separated by lands238 that constitute the inner surface 90 and therefore are equal inheight to the inner surface 90. The grooves 236 stretch across theentire length of the first plate intersecting each sidewall 94, 96 andbottom wall 98 of the staple holding locations 92. The staple holdinglocations 92 are configured for partially receiving and holding acomplementary, substantially U-shaped staple that is thicker than thethickness of the grooved sidewalls 94, 96, 98. In one variation, thestaple holding locations 92 receive the entire thickness of acomplementarily U-shaped staple as shown in FIG. 68 such that no portionof the staple 54 resides outside the staple holding location 92. Theslider 56 includes an angled caming surface 150 with a side surface thatis also formed with a plurality of horizontal grooves 240 formingchannels for receiving the upstanding lands 238 that are located betweenstaple holding locations 92. A second plate 84 or shim is not shown inFIG. 68 but together with the first plate 84 define a slot 120therebetween inside which the angled caming surface 150 of the slider 56is capable of translating interconnected on the side surface withinterlocked grooves 240 and lands 238. Because a staple 54 is residentin a grooved staple receiving portion 92, the angled caming surface 150of the slider 56 is still able to contact the outer surface 166 of thestaple 54 as the angled caming surface 150 translates through thegrooves 236 to urge staple 54 upwardly and out. The grooved innersurface 90 of the first plate 82 advantageously allows the use of verythin staples; for example, staples that are the same depth as the staplepocket depth or depth of the staple holding location 92. The depth ofthe staple pocket is approximately 0.0085 inches which is also thethickness of the staple 54 that can be used in this variation of theinvention. Therefore, the grooved plate 82 not only allows for extremelythin staples, it further reduces the size of the staple or allowsadditional space for structures that make the end effector stronger.

The stapler of the present invention is particularly suited forlaparoscopic procedures; however, the invention is not so limited andthe stapler of the present invention can be used in open surgicalprocedures equally effectively. In laparoscopic procedures, the staplerof the present invention can be used, for example, for the closure andanastomosis of tissue such as colon, small intestines, and stomach.

It is understood that various modifications may be made to theembodiments of the surgical stapler disclosed herein. Therefore, theabove description should not be construed as limiting, but merely asexemplifications of preferred embodiments. Those skilled in the art willenvision other modifications within the scope and spirit of the presentdisclosure.

We claim:
 1. A surgical stapler comprising: a handle assembly; acartridge assembly connected to the handle assembly; the cartridgeassembly having a proximal end and a distal end; the cartridge assemblycomprising; a jaw assembly at the distal end of the cartridge assembly;the jaw assembly comprising; a first jaw having an anvil surface; and asecond jaw having a top surface; the second jaw being movable relativeto the first jaw and having a closed position in which the anvil surfaceis adjacent to a top surface and a gap is defined between the topsurface and the anvil surface; the second jaw having a first surface anda second surface substantially parallel to each other and perpendicularto the top surface; the first surface and second surface defining afirst slot between the first surface and the second surface extendingalong a length of the second jaw; the first slot having a slot width;the first surface having a plurality of recesses formed into the firstsurface; each recess having a recessed wall, a front sidewall, and arear sidewall; the second jaw including a plurality of staple pockets;each staple pocket being defined by the recessed wall, front sidewall,rear sidewall, a bottom wall, second surface and an opening to the topsurface of the second jaw; an actuator coupled to the handle assembly; afirst caming surface having a thickness; the first caming surface beingmovable by the actuator within the first slot and along a length of thesecond jaw; and a plurality of staples positioned in the plurality ofstaple pockets; each staple having a staple width and being positionedwithin a pocket such that a portion of the staple width resides withinthe first slot and a portion of the staple width is located in therecess of the first surface; wherein, with translation of the firstcaming surface within the first slot, the first caming surface passesthrough one or more staple pockets making contact with that portion ofthe staple width resident within the first slot to urge the staple outof the opening and against the anvil surface.
 2. The surgical stapler ofclaim 1 wherein the first caming surface is angled with respect to thetop surface and the front sidewall and rear sidewall is perpendicular tothe angled first caming surface.
 3. The surgical stapler of claim 1wherein each staple includes a first leg interconnected by a base to asecond leg; the staple being substantially U-shaped in an openconfiguration; the first leg having a distal tip and the second leghaving a distal tip; the first leg being shorter in length relative tothe longer second leg; the staple being positioned within the recesssuch that the first leg is adjacent to the front sidewall and the secondleg is adjacent to the rear sidewall; wherein the anvil surface is asmooth surface without pockets and the second leg is deformed toward thefirst leg into a closed configuration when urged against the anvilsurface by the translating first caming surface; wherein the distal tipof the second leg slides along the anvil surface from the openconfiguration to the closed configuration.
 4. The surgical stapler ofclaim 1 wherein the second surface includes a plurality of recessesformed into the second surface opposite from the plurality of recessesformed into the first surface; each recess in the second surfaceincludes a recessed wall, a front sidewall, a rear sidewall and a bottomwall; each staple pocket being defined by the recessed wall, frontsidewall, rear sidewall and the bottom wall formed in the first surfaceand the recessed wall, front sidewall, rear sidewall and bottom wallformed in the second surface; the plurality of staples being positionedin the plurality of staple pockets such that a portion of each staple islocated in the recess of the first surface and a portion of each stapleis located in the recess of the second surface.
 5. The surgical staplerof claim 1 wherein the bottom wall is formed in the first surface andincludes a gap between the bottom wall and the front sidewall.
 6. Thesurgical stapler of claim 1 wherein the first surface is a side of anelongated first plate and the second surface is a side of an adjacentelongated second plate; the first plate being adjacent to the secondplate.
 7. The surgical stapler of claim 1 wherein the first plateincludes at least one spacer extending from the first surface toward thesecond surface.
 8. The surgical stapler of claim 1 wherein the secondjaw includes a third surface and a fourth surface substantially parallelto each other and perpendicular to the top surface; the third surfaceand fourth surface defining a second slot between the third surface andfourth surface and extending along a length of the second jaw; thefourth surface having a plurality of recesses formed into the fourthsurface; each recess having a recessed wall, a front sidewall, and arear sidewall; the second jaw includes a plurality of second slot staplepockets; each second slot staple pocket being defined by the recessedwall, front sidewall, rear sidewall, a bottom wall, third surface and anopening to the top surface of the second jaw; a second caming surfacehaving a thickness; the second caming surface being movable by theactuator within the second slot along a length of the second jaw; and aplurality of staples positioned in the plurality of the second slotstaple pockets such that a portion of the staple width resides withinthe second slot and a portion of the staple width is located in therecess of the fourth surface.
 9. The surgical stapler of claim 8 furtherincluding a blade movable along a length of the jaw assembly and withinthe gap defined between the top surface and the anvil surface when thefirst jaw and second jaw are in the closed position; the blade beinglocated between the first caming surface and the second caming surface.10. The surgical stapler of claim 8 further including a blade beingmovable along a length of the jaw assembly and within the gap definedbetween the top surface and the anvil surface when the first jaw andsecond jaw are in the closed position; the first caming surface and thesecond caming surface are located on one side of the blade.
 11. Thesurgical stapler of claim 8 wherein the first caming surface and secondcaming surface are connected comprising a unitary slider; the sliderbeing connected to the actuator.
 12. The surgical stapler of claim 8wherein the second surface and third surface are opposite sides of asingle elongated plate.
 13. The surgical stapler of claim 8 wherein thefirst surface is a side of an elongated first plate; the second surfaceand third surface are opposite sides of an elongated second plate; andthe fourth surface is a side of an elongated third plate.
 14. A surgicalstapler comprising: a handle assembly; a cartridge assembly connected tothe handle assembly; the cartridge assembly having a proximal end and adistal end; the cartridge assembly comprising; a jaw assembly at thedistal end of the cartridge assembly; the jaw assembly having alongitudinal axis; the jaw assembly comprising; a first jaw having ananvil surface; the anvil surface being a smooth and flat surface withoutpockets; and a second jaw having a top surface; the second jaw beingmovable relative to the first jaw and having a closed position in whichthe anvil surface is adjacent to a top surface and a gap is definedbetween the top surface and the anvil surface; the second jaw includinga plurality of staple pockets; each staple pocket having a longitudinalaxis and an opening at the top surface; an actuator coupled to thehandle assembly; at least one caming surface movable by the actuatorwithin the second jaw and along a length of the second jaw a pluralityof staples positioned in the staple pockets; each staple having an openconfiguration for penetrating tissue and a closed configuration forretaining tissue; the plurality of staples being located inside thestaple pockets in an open configuration; wherein, with the jaw assemblyin a closed position, translation of the caming surface along the secondjaw ejects the staples from the staple pockets toward the anvil surfaceof the first jaw to deform the staples from an open configurationagainst the anvil surface to a closed configuration.
 15. The surgicalstapler of claim 14 wherein each staple includes at least a first legand a second leg interconnected by base; and wherein the first leg has adistal end and the second leg has a distal end and the first leg of eachstaple is shorter in length relative to the second leg; wherein thesecond leg is deformed toward the first leg into a closed configurationwhen urged against the anvil surface by the translating first camingsurface.
 16. The surgical stapler of claim 15 wherein the longitudinalaxis of each staple pocket is angled with respect to the top surfacesuch that the second leg contacts the anvil surface before the first legand the distal tip of the second leg slides along the anvil surface; thesecond leg being deformed while a portion of the staple including thefirst leg remains substantially contained in the staple pocket.
 17. Thesurgical stapler of claim 15 wherein the distal end of the second leg ischamfered or curved toward the first leg to provide a predilection forthe staple to bend toward the first leg.
 18. A surgical staplercomprising: a handle assembly; a cartridge assembly connected to thehandle assembly; the cartridge assembly having a proximal end and adistal end; the cartridge assembly comprising; a jaw assembly at thedistal end of the cartridge assembly; the jaw assembly having alongitudinal axis; the jaw assembly comprising; a first jaw having ananvil surface; and a second jaw having a top surface; the second jawbeing movable relative to the first jaw and having a closed position inwhich the anvil surface is adjacent to a top surface and a gap isdefined between the top surface and the anvil surface; the second jawincluding a plurality of staple pockets having a plurality of openingsat the top surface; the staple pockets being arranged in at least threesubstantially parallel rows along the top surface of the second jaw; anactuator coupled to the handle assembly; at least one caming surfacemovable by the actuator along a length of the second jaw; a blademovable within the gap defined between the top surface and the anvilsurface when the first jaw and second jaw are in the closed position;the blade being configured to sever tissue located between the first jawand the second jaw defining a cutting line; a plurality of staplespositioned inside the plurality of staple pockets; wherein the camingsurface is configured to eject staples from the staple pockets andagainst the anvil surface to deform the staples with translation of thecaming surface along the second jaw; wherein the second jaw includes anumber of rows of staple pockets on one side of the blade that isdifferent from a number of rows of staple pockets on the other side ofthe blade.
 19. The surgical stapler of claim 18 further including avisual indication on the outer surface of jaw assembly to indicate tothe user which side of the jaw assembly delivers fewer rows of staples.20. The surgical stapler of claim 18 wherein the jaw assembly is curved.